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L Saltuari

Publications and source records attributed to L Saltuari.

At least 19 recordsLinked to original sources
PubMed1998

Epileptic seizure associated with intracerebroventricular and intrathecal morphine bolus.

We report on two patients with morphine-related seizures associated with either intrathecal or intracerebroventricular administration. Both patients had a history of malignant tumor and both experienced the seizures following bolus application of morphine, while even higher dosages were well tolerated when continuously infused. Seizures occurred without signs of intoxication. Initiation of intrathecal morphine therapy and bolus application should be performed carefully and only when constant monitoring is provided for at least 12 h. Animal data and possible mechanisms for morphine-related seizures are discussed.

Adult↗
PubMed1997

[Care of stroke patients by relatives--social support and coping strategies].

OBJECTIVE: To assess the coping ability and the social support of relatives looking after patients who have had a stroke. Of special interest was to ascertain how coping behaviour and social support differed between short-term (caring period of 3-6 months) and long-term (caring period longer than 2 years) carers. Differences in social networking between relatives and a control group (no caring tasks) were also assessed. SUBJECTS AND METHODS: A questionnaire based on the well-established "Berne coping forms" and another on social support were filled in by 20 relatives (18 women, two men; mean age 50.6 years) after a short-term caring period of up to 6 months and 20 relatives after a caring period longer than 2 years (14 women, six men; mean age 64.9 years) and a control group (27 women, 10 men; mean age 57.8 years). RESULTS: Among the total group of relatives the coping strategies (listed by order of importance) were: "passive cooperation", "acceptance", and "lending a hand". The short- and long-term carers showed no significant differences in these strategies. However, there were significant deficits in social support between the relatives and the controls as to practical support (P < 0.05), social integration (P < 0.01), social support received (P < 0.01), social burden (P < 0.01) and the caring persons (P < 0.05). There was no difference regarding social support between the short- and long-term carers. CONCLUSIONS: The results confirm the importance of social support for relatives who look after stroke patients. Every form of psychosocial help should be given at the time the patient is discharged to home care. This would require day clinics and short-term places in nursing homes.

Aged↗
PubMed1995

The impact of jejunal transplant peristalsis on enteric flora.

The importance of phase III of the migrating myoelectric complex (MMC) for homeostasis of enteric flora is well documented. The goal of this study was to evaluate in an isogeneic rat model the effect of MMC changes on the self-purging capacity of the jejunal graft. The proximal 25% of the entire jejunoileum of Lewis rats was transplanted orthotopically. Electrodes were then fixed to the graft. Native bowel of five rats and five rats with analogue jejunal segmentation served as controls. Myoelectric recordings were carried out until day 21, when animals were killed for bacteriologic analysis of the segments analyzed myoelectrically and the of neighboring gut. MMCs were observed in all animals during all recordings. Phase III was irregular in transplants because of long-lasting periods of phase III absence alternating with phase III occurring more frequently. The variation coefficient of phase III periodicity calculated for grafts was 48.74, for native bowel 14.79, and for segmented jejunum 22.9. Enteric flora found in all specimens consisted of colonic-like microorganisms. Titers of microorganisms in grafts did not differ from control segments. These findings show that phase III periodicity is severely altered in jejunal grafts. Homeostasis of enteric flora, however, is not influenced by the transplant procedure.

Animals↗
PubMed1995

Presence of Klùver-Bucy syndrome as a positive prognostic feature for the remission of traumatic prolonged disturbances of consciousness.

After severe brain injury a prolonged disturbance of consciousness may occur, sometimes with transient apallic syndrome (awakening without awareness of self and surroundings). Klùver-Bucy is described in the literature as a typical post-traumatic remission phase, in which the patients show an increase of oral automatisms and/or of sexual drive. The study describes Klùver-Bucy syndrome as a sign associated with favourable prognosis in the outcome of traumatic disturbances of consciousness in survivors of head trauma. Seventy-seven patients who had suffered severe brain injury due to traffic accidents entered into the study. All had experienced a relatively benign clinical course since they recovered full awareness, that is were able to communicate with their relatives. The occurrence of prolonged coma, of apallic syndrome and of Klùver-Bucy syndrome are related to outcome date in regards to the patient's work and family function at a mean of 32 months later. In particular, the duration of the apallic syndrome (duration of unconsciousness) was significantly correlated with the global outcome of the patients (p < 0.001).

Adolescent↗
PubMed1995

Early determination of neurological outcome after prehospital cardiopulmonary resuscitation.

BACKGROUND AND PURPOSE: Although there are various methods of determining neurological prognosis after cardiopulmonary resuscitation, the final outcome of patients often remains unclear for quite a long time. METHODS: We investigated 30 consecutively admitted patients who had been successfully resuscitated by the team of the local mobile intensive care unit after cardiac arrest. Determinations of the period of anoxia and of the cardiopulmonary resuscitation time, clinical investigation, echocardiography, electroencephalography, evoked potentials, magnetic resonance imaging, and magnetic resonance spectroscopy were performed. RESULTS: Demonstration of brain lactate in proton magnetic resonance spectroscopy (P < .01) and absent N20 waves in short-latency somatosensory evoked potentials (P < .01) proved to be significant in terms of a poor prognosis. Correlations between both duration of anoxia and cardiopulmonary resuscitation time and neurological outcome could be shown as well (both P < .05). CONCLUSIONS: Proton magnetic resonance spectroscopy and short-latency evoked potentials are of great benefit in the prognostic evaluation after cardiopulmonary resuscitation.

Adolescent↗
PubMed1994

Myoelectric activity during small bowel allograft rejection.

The effect of rejection on myoelectric activity of an orthotopically transplanted small intestinal segment (group I, N = 14) was studied. Electrodes were placed on grafts and recipient small bowel. Isografts (group II, N = 5) and native bowel (group III, N = 5) served as controls. The first morphological signs of rejection were seen on day 6 and steadily progressed until day 11, when the cellular infiltrate involved all layers of the bowel wall. Slow-wave frequencies remained unchanged throughout the observation period. No difference was detectable between grafts (group I: 31.9 +/- 1.65; group II: 31.36 +/- 0.7) and native bowel after transection (group I: 32.16 +/- 1.78; group II: 31.50 +/- 1.01), which was different (P = 0.0001) from intact bowel of group III animals (38.4 +/- 0.81). Irregular MMCs were detectable in grafts from day 5 on and replaced after food intake by random spiking activities. At day 8, spiking activities disappeared in allografts, which showed a still preserved mucosal architecture, while slow-wave activities continued. These findings demonstrate that intestinal allografts during rejection develop paralysis before mucosal destruction is established, which might be of clinical relevance.

Action Potentials↗
PubMed1994

Sleep spindles in the initial stages of the vegetative state.

The aim of this study was to look for the presence of spindling in the different stages of remission of the vegetative state to underline all possible correlations with lesional sites, severity of coma and final outcome. The nocturnal polygraphic recordings from 30 patients were examined: 20 (15M, 5F, mean age 31.7 years, range 16-41) had originally suffered a traumatic brain injury, 10 (4M, 6F, mean age 40.5 years, range 24-48) had hypoxic brain lesions. Evidence of spindling, always reduced in density and duration, was found in 44% of these patients, prevalently in the traumatic patients (53.3% versus 30% of hypoxic patients). No subjects in the full stage 0, 0-1 of the vegetative state (apallic syndrome) presented spindling. No significant correlation was found between spindling and the following parameters: gender, the time between the onset of coma and the polygraphic recording, or the site of the lesion.

Adolescent↗
PubMed1994

Epileptic seizures associated with intrathecal baclofen application.

We report the clinical and EEG findings in three patients presenting with seizures associated with intrathecal baclofen application for treatment of spasticity. All patients had a history of traumatic brain injury, while one patient also suffered a spinal cord injury. Two patients experienced their first seizure following intrathecal baclofen test bolus injection. Another patient had convulsions on two occasions: following postoperative baclofen dose adjustment, and after sleep deprivation. Structural brain disease seems prerequisite for baclofen to exert epileptogenic activity, since seizures have not occurred in patients receiving intrathecal baclofen for spasticity of solely spinal origin. Antiepileptic medication permitted the continuation of intrathecal baclofen treatment in the three patients.

Adolescent↗
PubMed1994

Post-traumatic mutism.

We report on the infrequent verbalisation disorder called "post-traumatic mutism" observed in 12 subjects with severe traumatic head injuries. These patients during the recovery of their conditions showed for a certain period a speechlessness even though some of them could communicate through gestures and writing. The nature and the possible mechanism of the disorder are discussed.

Adult↗
PubMed1994

Transcranial electrical stimulation in patients with apallic syndrome.

Muscle responses (MEPs) to transcranial electrical stimulation were studied in 7 patients with apallic syndrome. All the patients showed clinical signs of upper motor neurone impairment in the upper and lower limbs. MEPs were absent or markedly delayed in 4 of the 7 patients. Since patients with apallic syndrome show only minimal voluntary movement, transcranial stimulation is the only way to demonstrate abnormalities of fast corticospinal axons in these patients. Even though these patients often look similar clinically, with tetraplegia and decorticate or decerebrate posture, only some cases showed dysfunction of fast corticospinal neurons.

Adolescent↗
PubMed1993

Early removal of periarticular ossifications in patients with head injury.

Heterotopic ossifications are a well known but serious complication in patients suffering severe head injury. Their prevalence varies between 10% and 20%. The current concept of surgery recommends removal after "maturation" of the new developed bone because of a suspected higher rate of recurrence. The observations of early operations in 6 patients and 9 joints led us to the conclusion that the disadvantages of long lasting joint stiffness and the according complications outweigh the danger of recurrence. In our patients recurrence was observed in one subject and even there recurrence was most probably the result of wound infection and concomitant osteomyelitis.

Adolescent↗